Introduction:
Pharyngocutaneous fistula is the most common complication after total laryngectomy
and the most difficult to manage. It often causes increased morbidity, delays starting
of adjuvant therapy, prolongs hospitalization, increases treatment costs and reduces
quality of life. The aim of this study was to evaluate the impact of pectoralis major
myofascial flap in reducing pharyngocutaneous fistula rate after total laryngectomy.
Method:
Clinical retrospective study on 60 patients was conducted (30 patients with primary
closure without pectoralis major myofascial flap and 30 patients with primary closure
with pectoralis major myofascial flap) to assess fistula rate and risk factors. Details
of risk factors for pharyngocutaneous fistula were analyzed (age, gender, previous
tracheoctomy, comorbidities, tumor site, pathologic staging according to TNM, performance
of radical neck dissection).
Conclusion:
Advanced primary tumor staging and the age of patients were correlated with higher
incidences of pharyngocutaneous fistula. Using of prophylactic pectoralis major myofascial
flaps should reduce pharyngocutaneous fistula rate after total laryngectomy.
